Healthcare Provider Details

I. General information

NPI: 1235008640
Provider Name (Legal Business Name): MSC HEALTH TEXAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11910 US HIGHWAY 290 E UNIT 240
MANOR TX
78653-4332
US

IV. Provider business mailing address

10431 GULFDALE ST
SAN ANTONIO TX
78216-4130
US

V. Phone/Fax

Practice location:
  • Phone: 512-617-1050
  • Fax: 512-617-1051
Mailing address:
  • Phone: 210-775-1600
  • Fax: 210-742-1534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0500X
TaxonomyHemodialysis Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WN0300X
TaxonomyNephrology Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code163WD1100X
TaxonomyPeritoneal Dialysis Registered Nurse
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code246ZN0300X
TaxonomyNephrology Specialist/Technologist
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2472R0900X
TaxonomyRenal Dialysis Technician
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 9
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDRES GUTIERREZ
Title or Position: CEO
Credential:
Phone: 210-775-1600